Objective of the present study was estimation of the efficacy of surgical treatment in renal lithiasis by pyelolithotomy. The study was performed on a group of patients with urolithiasis treated in the Clinic of Urology and Surgical Nephrology, RCH during the years 2009-2010 and included 97 patients, 38 (39.2%) men and 59 (60.8% ) women undergoing surgical treatment by pyelolithotomy. The stone-free rate was of 96.9%, 3 patients’ residual stones were detected, which were resolved by ESWL. The most common postoperative complications were: fever - 30.9%, extravasation of urine - 27.8%, acute pyelonephritis - 14.4%, sepsis - 4.1%. Conclusion: pielolithotomy is actually surgical technique for treatment of kidney stones. In the absence of modern endoscopic treatment of urolithiasis as NLP, ESWL open surgery remains a successful alternative, with a high rate of “stone free” and a minimum recurrence frequency of complications, which differs from international authors.